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Ethics, practice, tools and problems in behavioral control (Proceedings)

A discussion of the ethics of behavioral treatment begins with some important topics. First, can you stick to the ethics of veterinary medicine and still be on firm footing with behavioral issues? Second, what does "do no harm" mean in the context of behavioral therapy? Third, how will you provide your clients with effective training and behavioral therapy?

Pica: Veterinary and Behavioral Ethics Illustrated

If you receive a patient with a gastric blockage, the decision about treatment is usually a slam-dunk — cut the dog open, fetch the sock and sew the whole mess back together. The immediacy of the malady makes dietary solutions and massage less likely to lead to the dog's survival and therefore they would become irrelevant treatments. The most common first resort of a correctly diagnosed intestinal blockage is invasive surgery.

Assuming that the surgery is successful, the dog will soon be moving around again. Ironically, your life-saving surgery has created a life-threatening behavioral problem. The delay between eating the sock and becoming unconscious and therefore insensate prevents the dog from making a connection between the sock-eating and the belly ache. i.e. Though the dog survived the experience, no conditioned association exists between the foreign object and the pain and discomfort of the surgery. Here's the overriding concern - the dog is now physically weakened and even more vulnerable to a blockage than prior to the surgery. Any additional sock-eating episodes are likely to be fatal. You are now presented with a critical question. What behavioral protocol is most likely to stop the dog from eating another sock in the future?

The Logical Answer: Outside the Norm

The three mainstays of modern behavioral therapy are gradual desensitization, counter conditioning and environmental management. In this setting, these commonly recommended tools are useless. First, your goal is to make the dog never eat another sock. This is a form of training that requires aversive control. (Avert literally means "to turn away" - the antithesis of positive reinforcement.) There is no application or removal of treats or affection that will prevent this behavior from happening. Counter conditioning, the teaching of an acceptable alternate behavior, is also ineffective. EG: Teaching a dog to eat chicken isn't going to stop him from eating beef when he can get it.

Another bedrock suggestion for solving this problem is environmental management - meaning to "puppy proof" the house - forever. This suggestion is rarely, if ever, 100% effective. Dogs are natural hunters and all that implies. If you block their access to favored items they will simply switch to new items or actively hunt for things to chew. They will knock down kiddy gates, climb on bookshelves and open doors to get what they want. Eventually someone in the family leaves a door open or the dog knocks down or chews through the kiddy gate. The only solution to the problem of potentially lethal pica is to permanently inhibit the behavior. The only behavioral tool likely to achieve that is some form of corporal punishment.

The Ethical and Practical Problem: What does "do no harm mean"?

OK. Now you know the behavior has to be stopped, cold. Deciding on the ethics of stopping the behavior should ideally follow the same reasoning you used to give surgical treatment. When you selected surgery as a first resort for the obstruction you chose the method most likely to keep the dog alive. You didn't have a problem with inflicting pain and suffering on the dog in the event that he recovered. Now that the dog is in desperate need of an inhibition, you run smack into a political bombshell. Cautions about using punishment are virtually everywhere in both popular and scientific literature.

These cautions usually fall into two basic categories: the dog will suffer mental trauma, fear and "stress" from a punishing experience and punishment doesn't really work.

Dangerous Stress and Fear:

In the case of our pica dog, the trauma, fear and stress that must be avoided in a behavioral treatment are ironically part of the surgical procedure. The surgery caused physiological stress as will the pain and limited movement during recuperation. Fear, the intangible boogeyman, is common in veterinary practice and there is no assurance that the experience of having surgery won't cause "fear." In essence, no one balked at opening the peritoneum because of stress, pain or fear, yet these are the very reactions that prevent the immediate application of a post surgical punishment procedure. This appears to be a logical contradiction rather than an ethical conundrum.